麻醉深度与术后远期死亡率

Depth of anesthesia and postoperative long term mortality

背景近年研究发现术后死亡率与麻醉过深有关。有报道指出累计深睡眠持续时间[累计低脑电双频指数（bispectralindex，BIS）值持续时间]是进行非心脏大手术术后1年死亡率的独立预测因子。随后几项著名的关于BIS监测预防术中知晓的随机对照试验（randomizedcontroltrial，RCT）研究，根据术后随访和对资料的二次分析，也证实术后远期死亡率与深睡眠存在相关性。此外，又发现重症监护室（ICU）中使用镇静药物的患者，经历脑电图（EEG）爆发性抑制的患者与没有经历爆发性抑制的患者相比较，远期死亡率明显升高。目的探讨累计深睡眠持续时间是否与远期死亡率存在一定关系。内容此篇综述简要阐述分析了目前有关麻醉深度与远期死亡率的相关研究。趋势认识到深睡眠与死亡率之间存在一定相关性，这需要我们更深一步研究这一问题。

Background Recently postoperative mortality has been found associated with cumulative anesthetic duration of low BIS（bispectral index）. It was reported that cumulative deep hypnotic time （cumulative duration of low BIS） was an independent predictor of 1-yr mortality after major noncardiac surgery. Previously a few notable published randomized control trial reports confirmed the mortality- hypnosis association. These reports a11 derived from secondary analyses of data, which were to evaluate the effect of BIS monitoring on the incidence of intraoperative awareness. Other report found the ICU patients who under sedation experienced burst suppression had a significant higher 6-month mortality rate compared with patients who did not have burst suppression. Objective To discuss whether there will be a connection between cumulative anesthetic duration of low BIS and long term mortality. Content This review briefly demonstrates the relationship between depth of anesthesia and long term mortality. Trend It needs further investigation to recognize the correlation between deep hypnosis and mortality.